Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The consultation begins with a thorough examination of the patient’s facial anatomy. The surgeon assesses the thickness of the cheek tissue, the presence of buccal fat, and the underlying muscle structure. This physical exam determines which surgical technique will yield the best results.
The surgeon also evaluates facial animation. The patient is asked to smile, pucker, and relax their face so the surgeon can observe the natural movement of the zygomaticus muscles. This dynamic assessment is crucial for placing the dimple where it will look most natural during expression.
Finding the perfect location is a mix of anatomical science and patient preference. The surgeon typically marks the intersection of the horizontal line from the corner of the mouth and the vertical line from the lateral canthus (the outer corner of the eye).
The patient is then given a mirror to provide feedback. The surgeon may use a Q-tip to press into the cheek at various points to simulate the dimple. This interactive process ensures the patient is happy with the proposed location before any incision is made.
A comprehensive review of the patient’s medical history is mandatory. The surgeon checks for conditions that could impair healing, such as diabetes or autoimmune disorders. A history of keloid scarring is a significant contraindication, as a keloid in the cheek could be problematic.
Bleeding disorders are also assessed. Since the mouth is a vascular area, any clotting issues must be managed. The surgeon also asks about oral herpes (cold sores), as the stress of surgery can trigger an outbreak, requiring antiviral prophylaxis.
Because the incision is inside the mouth, oral health is paramount. The surgeon inspects the inside of the cheeks, gums, and teeth. Active gum disease, abscesses, or severe plaque can increase the risk of postoperative infection.
Patients with poor oral hygiene may be advised to see a dentist for a cleaning before the procedure. A clean oral environment drastically reduces bacterial load and the risk of complications such as cellulitis or abscess formation at the surgical site.
The surgeon spends significant time discussing realistic outcomes. Patients must understand that the dimple will be static (visible all the time) for several weeks or months before becoming dynamic. They must also accept that symmetry is never guaranteed due to natural facial differences.
The surgeon explains that dimples may fade over time and require a touch-up. Setting these expectations prevents postoperative dissatisfaction. The goal is a natural enhancement, not absolute perfection.
Standardized preoperative photographs are taken from multiple angles: resting, smiling, and grimacing. These photos serve as a medical record and a baseline for comparing results.
While digital simulation is less common for dimples than for nose jobs, some surgeons use software or simple physical manipulation (pushing on the cheek) to show the approximate effect. The photos are also used to analyze existing asymmetries that the patient might not have noticed.
For young, healthy patients, extensive testing is rarely needed. However, older patients or those with medical conditions may require blood work (Complete Blood Count, coagulation profile) to ensure safety.
If there is any concern about the parotid duct’s location or other anatomical anomalies, imaging might theoretically be requested, though this is extremely rare for a standard dimpleplasty. The focus is usually on basic physiological stability.
Patients are instructed to stop taking blood-thinning medications and supplements for at least 10 to 14 days before surgery. This includes aspirin, ibuprofen, Vitamin E, fish oil, and ginkgo biloba. These substances increase bleeding and bruising.
The surgeon may also prescribe antibiotics to be started the day before or the day of surgery to prevent infection. Arnica montana may be recommended to help reduce postoperative bruising and swelling.
Nicotine is a vasoconstrictor that impairs blood flow and slows healing. Smoking significantly increases the risk of infection and wound breakdown inside the mouth. It can also lead to poor scar formation, resulting in the dimple failing.
Patients are strongly advised to stop smoking or vaping for at least two weeks before and after the procedure. This ensures the delicate tissues of the cheek have an adequate blood supply to form the necessary adhesion.
Since the incisions are in the mouth, diet plays a role in preparation. Patients are advised to eat a solid meal before surgery, as they may not want to eat immediately afterward while the mouth is numb.
Postoperative dietary restrictions are also discussed during the consultation, so the patient can stock up on supplies. This includes soft foods, cool liquids, and avoiding spicy or acidic items that could irritate the fresh incisions.
The surgery is outpatient, but patients still need to plan. They should arrange for transportation if they are receiving any sedation, although most can drive themselves if only local anesthesia is used.
Patients should plan to take the rest of the day off work. While recovery is quick, facial swelling can be noticeable. Social events should be scheduled with the understanding that the cheeks will be swollen and the dimples will be very prominent initially.
The final step is the informed consent process. The surgeon reviews all potential risks, including infection, asymmetry, loss of the dimple, damage to the parotid duct (rare), and nerve injury (rare).
The patient signs documents acknowledging they understand the permanent nature of the procedure and the risks involved. This ensures that the decision to proceed is made with full awareness of all possible outcomes.
Send us all your questions or requests, and our expert team will assist you.
Stand in front of a mirror and smile widely. Look for the spot where the crease of your smile would naturally extend. Usually, this is where the corner of your mouth lines up with the outer corner of your eye. Use a makeup pencil to mark it and see if you like it.
You should avoid alcohol for at least 48 hours before surgery. Alcohol thins the blood and can increase bleeding and bruising during and after the procedure.
Yes, you should brush your teeth and floss thoroughly before your appointment. A clean mouth reduces the amount of bacteria at the incision site, lowering the risk of infection.
You can still have dimpleplasty with braces, but it might be slightly more uncomfortable. The hardware can rub against the swollen cheeks. Your surgeon will check to ensure there is enough space to operate safely.
Revision surgery is generally no more painful than the original procedure. It is performed under local anesthesia. However, because there is scar tissue, there might be slightly more swelling afterwards.
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